Immunization Schedule

Patient Education

What schedule should be followed for vaccinating my child?

Schedules for immunization varies in different countries based on the prevalence of various infections in their area. The ACIP/CDC for the USA is depicted in table 1.

Table 1: General Recommendation from ACIP/CDC from Newborn to 18 yrs. of age

The Government of India has recommended the National immunization schedule, which is followed in all government hospitals and clinics. It provides vaccination against 8 diseases free of cost to all children who visit government facilities.

BCG- against tuberculosis

OPV- Oral Polio Vaccine

Hep B- Hepatitis B

HiB- H. influenza B

DPT- Diphtheria, Pertussis, Tetanus

TT- Tetanus toxoid

However, there are additional vaccines in the market, which prevent important diseases, including viral diarrhea and pneumonia, which ideally should be given to children. These are included in the Indian Academy of Pediatrics (IAP) schedule:

IPV- Injectable (killed) Polio Vaccine

PCV- Pneumococcal conjugate vaccine

MMR- Measles, Mumps, Rubella

Hep A- Hepatitis A

Td- Typhoid, diphtheria

Tdap- Typhoid, diphtheria, acellular pertussis

Are there additional vaccines needed in special situations apart from the routine vaccines?

There are certain situations called High-risk situations that place a child or a person at greater risk for contracting serious infections than the general population. Hence, these children need additional vaccinations to protect them from these diseases.

These conditions include:

1. Congenital or acquired defects in the immune system (including HIV infection, cancers)
2. Chronic heart, lung (including asthma if treated with prolonged high-dose oral corticosteroids), blood, kidney(including nephrotic syndrome) and liver disease;
3. Children on long term steroids, salicylates, immunosuppressive or radiation therapy;
4. Diabetes, Cochlear implant,
5. During disease outbreaks
6. Laboratory personnel and healthcare workers
7. Travelers
8. Children having pets at home;
9. Children perceived with a higher threat of being bitten by dogs such as hostellers, risk of stray dog menace while going outdoor.

The vaccines include:

1. Influenza Vaccine
2. Meningococcal Vaccine
3. Japanese Encephalitis Vaccine
4. Cholera Vaccine
5. Rabies Vaccine
6. Yellow Fever Vaccine
7. Pneumococcal Polysaccharide Vaccine (PPSV 23)

How should vaccination be given in preterm babies?

Since vaccines given at birth are BCG, OPV and Hepatitis B. Studies show that response to the hepatitis B vaccine may be diminished in infants with birth weight less than 2000 grams after administration of the hepatitis B vaccine at birth. However, by 1 month of chronologic age, all preterm infants, regardless of initial birth weight or gestational age, are as likely to respond as adequately as do older and larger infants. Thus BCG, OPV, and Hepatitis B should be given in preterm infants weighing <2000 grams and born to HBsAg-negative mothers at 1 month of postnatal age if medically stable or at hospital discharge.